Journal of Liver Transplantation最新文献

{"title":"The impact of recipient age on the post-liver transplant prognosis of simultaneous liver and kidney transplantation","authors":"D.U. Lee ,&nbsp;K.J. Lee ,&nbsp;Y.J. Cha ,&nbsp;G.H. Fan ,&nbsp;M.R. Shaik ,&nbsp;K. Bhowmick ,&nbsp;H. Chou ,&nbsp;C. Sun ,&nbsp;H. Chou ,&nbsp;R. Malik","doi":"10.1016/j.liver.2025.100275","DOIUrl":"10.1016/j.liver.2025.100275","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Simultaneous liver and kidney transplant (SLKT) can be a life-saving procedure for those with liver failure and concomitant kidney disease. This study evaluates the post-transplant outcomes and prognosis based on the recipients’ age using the UNOS-STAR database.</div></div><div><h3>Methods</h3><div>Using the UNOS-STAR registry (2005–2019), patients who underwent SLKT were selected. They were stratified by the recipients’ each age cohort. Those under the age of 18, retransplantation, and with prior liver transplantation were excluded. Iterative Cox regression was performed on multiple mortality endpoints to assess the prognostic effects.</div></div><div><h3>Results</h3><div>From 5748 SLKT patients, there were five age groups of recipients: ages 18–39 (<em>n</em> = 371), quadragenarian (<em>n</em> = 759), quinquagenarian (<em>n</em> = 2112), sexagenarian (<em>n</em> = 2202), and septuagenarian (<em>n</em> = 183). The median follow-up time was 3.03 years (25–75 % IQR: 1.02–7.00). Assessing the primary endpoints, the sexagenarian recipients had a significantly lower incidence of graft failure compared to the controls (aHR 0.36, 95 % CI 0.19–0.68, <em>p</em> = 0.002). The septuagenarian recipients experienced a higher incidence of all-cause mortality compared to the controls (aHR 2.08, 95 % CI 1.34–3.21, <em>p</em> = 0.001). However, the quadragenarian and quinquagenarian recipients did not have significant differences in all-cause mortality and graft failure. Evaluating the end-organ outcomes, there were no significant differences obtained among the recipients with various age cohorts.</div></div><div><h3>Conclusion</h3><div>This study demonstrates the advanced age of transplant recipients with SLKT was associated with increased all-cause mortality. Therefore, certain groups of SLKT recipients had differential impacts based on the chronicle ages.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"19 ","pages":"Article 100275"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current knowledge about immunotherapy response after liver transplantation of patients with liver cancer","authors":"W. Gaya Shivega ,&nbsp;Xin Wei Wang ,&nbsp;Shay Behrens","doi":"10.1016/j.liver.2025.100285","DOIUrl":"10.1016/j.liver.2025.100285","url":null,"abstract":"<div><div>Hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (iCCA) are the two main liver cancers responsible for cancer deaths worldwide. Multiple etiologies exist driving these diseases; however, there are limited effective treatments to date. Recent studies have demonstrated improved outcomes in patients with advanced disease treated with immune checkpoint inhibition (ICI). Further, as these patients undergo liver transplantation, it’s critical to have an understanding of the impact of ICI on the immune system post-transplantation. In this review, we will provide an overview on ICI therapy in liver cancer, ICI utilization in the peri-transplantation setting, and discuss molecular predictions to immunotherapy response.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"19 ","pages":"Article 100285"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biliodigestive anastomotic strictures after liver transplantation: a comparison between temporary covered metal stents and drain calibration","authors":"Angelo Della Corte ,&nbsp;Antoine Breton ,&nbsp;Xavier Muller ,&nbsp;Kayvan Mohkam ,&nbsp;Guillaume Rossignol ,&nbsp;Jules Cœur ,&nbsp;Ammar Fooz ,&nbsp;Agnès Rode ,&nbsp;Jean-Yves Mabrut","doi":"10.1016/j.liver.2025.100289","DOIUrl":"10.1016/j.liver.2025.100289","url":null,"abstract":"","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"19 ","pages":"Article 100289"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A geospatial analysis of liver transplant centers and alcohol-related liver disease across the United States","authors":"Luke M. Tomasovic ,&nbsp;Jeremy R. Ellis ,&nbsp;Alexander C. Schulick ,&nbsp;Parth Agrawal ,&nbsp;Anmol Warman ,&nbsp;Andrew M. Cameron ,&nbsp;Elizabeth A. King","doi":"10.1016/j.liver.2025.100290","DOIUrl":"10.1016/j.liver.2025.100290","url":null,"abstract":"<div><div>Alcohol-related liver disease (ARLD) represents a major cause of end-stage liver disease and has surged as a leading indication for liver transplantation. This study investigates geographic disparities in liver transplant center availability relative to the regional burdens of ARLD mortality and alcohol use disorder (AUD) prevalence in the U.S. Using state-level data from publicly available databases, we evaluated the relationships between liver transplant center density, ARLD mortality, and AUD prevalence. We also developed two novel metrics: the AUD prevalence-to-transplant recipients (AUDT) ratio and the ARLD deaths-to-transplant recipients (ARLDT) ratio. These ratios served as proxies for assessing disparities between the need for and access to liver transplant services. Our findings reveal that while AUD prevalence and AUDT ratios did not significantly vary with transplant center density, higher ARLD mortality per capita and ARLDT ratios were correlated with lower transplant center density. States without a transplant center also experienced significantly higher ARLD mortality per capita compared to states with at least one transplant center per 100,000 square miles. These findings underscore the significant role of geographic factors in accessing transplant care and suggest that barriers to transplant centers may contribute to outcome disparities among patients with ARLD. The study also highlights the need for targeted healthcare planning and policy interventions to enhance liver transplant access, particularly in regions with disproportionately high ARLD burdens and limited transplant infrastructure. Future research should utilize more granular geographies, such as transplant referral regions, and incorporate covariates related to overall healthcare infrastructure and access.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"19 ","pages":"Article 100290"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144695147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid defatting of macrosteatotic liver grafts: A radiologic proof-of-concept study","authors":"Pierre De Mathelin,&nbsp;Thierry Artzner,&nbsp;Baptiste Michard,&nbsp;Philippe Bachellier,&nbsp;François Faitot,&nbsp;Pietro Addeo","doi":"10.1016/j.liver.2025.100283","DOIUrl":"10.1016/j.liver.2025.100283","url":null,"abstract":"<div><div>None</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"19 ","pages":"Article 100283"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pure living donor liver transplant for liver and polycystic kidney disease, outcomes and experiences from an Asian transplant unit","authors":"Darren W. Chua ,&nbsp;Horng-ren Yang ,&nbsp;Ping Chun Li ,&nbsp;Sheng-Hsien Chen ,&nbsp;Shih Chao Hsu ,&nbsp;Te-Hong Chen ,&nbsp;Hsueh-Chou Lai ,&nbsp;Ching-Feng Wu ,&nbsp;You-Cian Lin ,&nbsp;Long-Bin Jeng","doi":"10.1016/j.liver.2025.100272","DOIUrl":"10.1016/j.liver.2025.100272","url":null,"abstract":"<div><h3>Background</h3><div>Adult polycystic liver disease (PLD) is a rare genetic disorder. In instances of intractable symptoms from mass effect or recurrent cyst-related complications, liver transplant affords the best therapeutic solution.</div></div><div><h3>Methods</h3><div>This is a retrospective case series of patients who underwent isolated pure living donor liver transplantation (LDLT) for adult polycystic kidney disease (PCKD) associated PLD from 2012- 2022. Short-term peri‑operative outcomes including renal sequelae and long-term survival were analysed.</div></div><div><h3>Results</h3><div>From 2012–2022, a total of 9 patients underwent LDLT for PLD. The median explanted liver weight was 6950 g (IQR 5653–7700) with a median blood loss of was 5450mls (IQR 2400–9875). There was 1 mortality due to acute antibody-mediated rejection (11.1 %). Of the four patients with existing chronic kidney disease (CKD), 2 (50 %) developed end-stage renal failure and was renal replacement therapy (RRT) dependent at 3 months. The median overall survival in our series was 63.9 months with a 5-year survival of 88.9 %.</div></div><div><h3>Conclusions</h3><div>Despite its technical challenges, LDLT affords an excellent long-term prognosis with acceptable major morbidity. Pre-operative CKD appears to be a risk factor for early renal deterioration.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"18 ","pages":"Article 100272"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular evidence of solitary lung metastasis as the initial recurrence of hepatocellular carcinoma a decade more after liver transplantation","authors":"Cheng-Maw Ho ,&nbsp;Hsao-Hsun Hsu ,&nbsp;Hui-Ling Chen ,&nbsp;Po-Huang Lee ,&nbsp;Rey-Heng Hu","doi":"10.1016/j.liver.2025.100266","DOIUrl":"10.1016/j.liver.2025.100266","url":null,"abstract":"","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"18 ","pages":"Article 100266"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143465449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of recipient sex in the post-liver transplant prognosis of acute-on-chronic liver failure","authors":"David Uihwan Lee ,&nbsp;Mohammed Rifat Shaik ,&nbsp;Sharmitha Yerneni ,&nbsp;Ashton Harmacinski ,&nbsp;Nishat Anjum Shaik ,&nbsp;Katie Evey ,&nbsp;Kuntal Bhowmick ,&nbsp;Zainab Mujahid ,&nbsp;Youngjae Cha ,&nbsp;Hannah Chou ,&nbsp;Andrew Yi ,&nbsp;Kijung Lee ,&nbsp;Gregory Hongyuan Fan ,&nbsp;Raza Malik","doi":"10.1016/j.liver.2025.100267","DOIUrl":"10.1016/j.liver.2025.100267","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Limited data exists on the impact of recipient sex on the post-liver transplant (LT) outcomes in patients with acute-on-chronic liver failure (ACLF). This study aims to utilize a national transplant registry to evaluate the relationship between recipient sex and post-transplant outcomes, stratified by ACLF severity.</div></div><div><h3>Methods</h3><div>The United Network for Organ Sharing Standard Transplant Analysis and Research (UNOS-STAR) database was queried to collect health information on 47,447 patients who underwent liver transplantation between 1987 and 2019. The cohort was stratified by biological sex, and further subdivided into groups based on ACLF severity: Grade 0 (without ACLF) and Grade 1–3 in increasing severity. The primary outcomes assessed were all-cause mortality and graft failure while secondary outcomes included specific causes of death.</div></div><div><h3>Results</h3><div>No sex-based disparities were observed in the primary outcomes of all-cause mortality and graft failure across all grades of ACLF. However, females without ACLF exhibited a higher risk of mortality from recurrent graft disease compared to males. Time-point analyses revealed higher 180-day and 360-day mortality rates in females without ACLF. Among patients with ACLF Grade 1, females demonstrated higher 30-day mortality, but no significant differences were found at 90-, 180- or 360-days. Among patients with ACLF Grades 2 and 3, however, no sex-based differences in 30-day to 360-day mortality were identified.</div></div><div><h3>Conclusion</h3><div>Factors other than sex appear to play a more critical role in determining the long-term transplant outcomes in ACLF. The increased short-term mortality observed in females with ACLF grade 1 warrants further investigation to elucidate potential contributing factors.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"18 ","pages":"Article 100267"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary experience in anesthetic management of patients undergoing auxiliary liver transplant according to the RAPID procedure","authors":"Marie-Hélène Lagios ,&nbsp;Audrey Dieu ,&nbsp;Loïc Benoit ,&nbsp;Arnaud Steyaert ,&nbsp;Virginie Montiel ,&nbsp;Aude Vanbuggenhout ,&nbsp;Lancelot Marique ,&nbsp;Laurent Coubeau","doi":"10.1016/j.liver.2025.100268","DOIUrl":"10.1016/j.liver.2025.100268","url":null,"abstract":"<div><h3>Background</h3><div>RAPID (Resection And Partial Liver Transplantation With Delayed Total Hepatectomy) is a novel two-stage surgical procedure, with only 23 reported cases, involving partial liver resection and transplantation of a left lobe (stage 1) followed by a delayed total hepatectomy (stage 2). The perioperative anesthetic management of these recipients presents unique challenges and has never been described so far.</div></div><div><h3>Materials and methods</h3><div>We report on ten patients with unresectable liver metastases who underwent this procedure from a living donor in our center between May 2020 and April 2024. Retrospectively, we collected preoperative, graft-related, and intraoperative management data during stage 1 (S1) and stage 2 (S2), and postoperative outcomes.</div></div><div><h3>Results and discussion</h3><div>Recipients’ median age was 53 (50–57), median graft-to-recipient weight ratio 0.43 % (0.41–0.45), total ischemia time 82 min (75–105). No patients experienced postreperfusion syndrome. Median intensive care unit (ICU) stay was 36 h (27–48) after S1, 24 h (24–48) after S2. Median INR on POD 3 was 1.20 (1.13–1.29) after S1, 1.29 (1.16–1.70) after S2. Complications after S1 included portal thrombosis in one patient, and three required revision surgery. After S2, one patient required revision for hemostasis, and another developed acute kidney injury. This patient died on day 12 from bleeding post-thoracocentesis for pleural effusion. Six-month survival rate was 90 %.</div></div><div><h3>Conclusions</h3><div>These preliminary data, as a first step in developing perioperative management protocols for this innovative surgery, show good hemodynamic tolerance, no postreperfusion syndrome, and preserved liver function throughout the process. These results highlight the RAPID procedure's safety during surgery and postoperative course.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"18 ","pages":"Article 100268"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of donor anemia on post-liver transplant outcomes: A stratified analysis by cold ischemia time","authors":"David Uihwan Lee ,&nbsp;Mohammed Rifat Shaik ,&nbsp;Kuntal Bhowmick ,&nbsp;Youngjae Cha ,&nbsp;Ki Jung Lee ,&nbsp;Nishat Anjum Shaik ,&nbsp;Gregory Hongyuan Fan ,&nbsp;Miranda Tsang ,&nbsp;Eddie Kwon ,&nbsp;Hannah Chou ,&nbsp;Harrison Chou ,&nbsp;Raza Malik","doi":"10.1016/j.liver.2025.100270","DOIUrl":"10.1016/j.liver.2025.100270","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Cold ischemia time (CIT) has long been correlated with liver transplant (LT) graft viability. Donor anemia, leading to suboptimal oxygen delivery to the liver, may theoretically worsen the ischemia-reperfusion injury associated with CIT. In this study, we stratify CIT by tertiles and investigate the potential relationship between donor anemia, CIT, and LT-recipient prognosis by varying donor hematocrit (Hct) thresholds.</div></div><div><h3>Methods</h3><div>The United Network for Organ Sharing (UNOS) Standard Transplant Analysis and Research (STAR) Database was used to study LT patients between 2005 and 2019. Patients were categorized into tertiles by donor Hct thresholds of &lt; 27.6, 27.6-32.3, and &gt; 32.3, and compared amongst all CIT and set thresholds. Primary outcomes assessed were all-cause mortality and graft failure.</div></div><div><h3>Results</h3><div>All study results are reported in comparison to LT recipients with donor Hct below 27.6. In the composite population encompassing all CIT thresholds, LT recipients experienced higher all-cause mortality (aHR 1.04; 95% CI 1.00-1.08, p=0.05), as well as graft failure (aHR 1.10; 95% CI 1.01-1.20, p=0.02) with donor Hct above 32.3. There were no significant differences in primary outcomes within the first CIT tertile. Recipients within the 2nd CIT tertile experienced higher rates of graft failure with Hct above 32.3 (aHR 1.17; 95% CI 1.01-1.37, p=0.04). Higher all-cause mortality was observed in recipients with donor Hct above 32.3 (aHR 1.07; 95% CI 1.00-1.14, p=0.04) within the 3rd tertile of CIT.</div></div><div><h3>Conclusion</h3><div>Normal donor Hct and mild donor anemia were associated with worse LT-recipient outcomes when compared to moderate-to-severe donor anemia. This may potentially represent a local adaptation in the donor graft from chronic anemia or a multifactorial, organization-based process. These associations warrant further investigation.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"18 ","pages":"Article 100270"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}